This blog describes and tracks an annual study abroad program for occupational therapy students and occupational therapists to Ghana, West Africa. The program is run through the department of occupational therapy in the school of Allied Health Professions at Virginia Commonwealth University.

Saturday, July 18, 2009

I have become a follower of Penelope Trunk's Brazen Careerist blog. I don't take the information on there too seriously, but I find it entertaining and there are little pearls of wisdom that I can't help but reflect on and take to heart. One such blog talks about people who live in New York; that the people who live in NYC are optimizers, people who strive to make the best of themselves and who just don't settle for good enough. I have been called a perfectionist before, but I don't think that I am: I am fine with spelling mistakes on my blog for instance. But I do think I would fit the profile of an optimizer. I have difficulty relishing that I led a relatively successful study abroad course without then mulling over how it could have been better, or how I can make it better next time. There are two parts (at least) to this "betterment". There is better for the students educational experience and there is better in terms of providing service to people with disabilities in Ghana.

I will post later about the educational piece, but today I will give you my top three thoughts on how to better our service work for people with disabilities in Ghana.

1) See Less, Do More - While I loved being able to see something new everyday in Ghana, I think that our limited stints at most of the centers we visited resulted in our inability to accomplish anything sustainable or meaningful. In most cases we were seen as just another group of Westerners coming through for a tour. For this next trip I plan conduct service-learning projects at 2-3 sites; preferably with at least one of those sites being for adults with disabilities. Projects will be identified ahead of time, hopefully in conjunction and collaboration with in-country partners, and the students will spend the spring semester working on teams to prepare for project execution. During the trip, students will still get a variety of experiences but most of their work will be focused on one project at one center.

2) Clearly Establish Goals and Responsibilities- While there is something to be said for flexibility and adaptability, it can also be frustrating to have certain expectations for an experience and not have those expectations met when you have traveled half way around the world. In any relationship, it is important to have common goals and a clear outline of who will do what. In preparation for next year's trip, I would like to develop service-learning agreements with each of our partner sites. These agreements would list the common goal for the students visit (e.g. establishing a computer training program for adults with physical disabilities) and the responsibilities of the in-country director and their staff, the program director (me) and the students. This agreement could include monetary payments to the facility (because the expect a donation whether they ask for it or not)and service work other than training (because they might want you to also paint a building). If there is work that will need to be done by the program director before your visit (like making sure the site is wired for electricity) or after the visit (record client progress in attaining jobs at 3 months and 9 months) then this could be put in the agreement as well. This document will have no legal standing, but can serve to clarify goals, expectations, and responsibilities in a way that is more tangible than a conversation, an e-mail, or a handshake.

3) Get to the Higher-Ups: My students were quick to point out that changes were needed in Ghana and that these changes were going to need to come from higher up. In this case, higher up could either mean the government or people in positions of power such as tribal chiefs, university professors/graduates (people with high levels of education), church leaders, or wealthy businessmen. If we want any of our programs to have credibility or sustainability we will need to find people of prominence to partner with and continue to support our programs throughout the entire year. This will take time, but I will need to consider this in planning for the next trip.

Monday, July 6, 2009

So meeting Enoch was hands-down the most powerful moment of the trip for me. It was like seeing all of these kids that we had met so far, all grown up. We met Enoch on the streets of Accra, in an area that was referred to (by our hosts) as the 'slums'. Sounds nice, right? We were told that this is the area that the homeless, particularly the disabled homeless, came at night to sleep once all of the shops closed up. During the day, these people faced hours upon hours in the hot African sun begging on the streets.

It was Sunday, so the shops in the market were closed (they actually close things down on Sunday in Ghana, wow) and people with disabilities literally lined the streets. I admit, I had almost a lustful urge to talk to them all, to hear all of their stories.

Enoch was seated with his family, a hodge podge of children and adults that shared a common area on one side of the street. In a tee-shirt and jeans he look relaxed enough until he saw our guide (Felecia) coming through with a troupe of westerners. Immediately, when she approached him, he began yelling (in Twi) and gesturing (angrily) towards us. Though my Twi is pathetic at best, I got the gist of what he was saying: I'm not some display, why are you here, you have done nothing to help me.

Apart from being taken aback (most Ghanaians really are very friendly to westerners), my immediate feeling was "that's right, you should be pissed off". I mean, come on, you get a bad polio shot when your a kid, you loose most of the function in your lower extremities, you get discriminated against all your life, you have to beg on the streets to support your family because there are no government supports for people with disabilities (or there weren't when you were growing up), and now some white women from the US are going to come by to see what you're up to! Ya, I think getting kind of angry was an appropriate emotional response.

Now, Felecia who is the amazing wife of Eric from SGM, talked to Enoch about who we were an what we were studying. It turns out that Enoch also spoke fabulous English (though I think he yells better in Twi), so I got to talk to him directly about what our goals were. It turns out, he was more than happy to discuss the Ghanaian disability laws with us and his experiences trying to get support from social welfare. He was interested to hear what occupational therapists did (he had heard of PT but not OT, of course!) and was appreciative of what we were trying to accomplish on this trip.

We had heard from other Ghanaians that we talked to that the "street people" wanted to be there, that they didn't want to get real jobs. In fact, Enoch and his friend want to learn to work with fabric and design clothing (a very popular and fantastic trade in Ghana). Here are the problems: 1) options for where he could learn this trade are limited, 2) they cost money, 3) they do not allow men to bring their families with them, 4) he could not work while he learned the trade so his family would have no support while he was away, 5) once he learned the trade there was no gov. support to get start up materials or space to start his own shop/business, and 6) even if he started his own business Ghanaians would likely not buy from him due to the negative stigma surrounding people with disabilities (e.g. evil spirits, witchcraft...).

So, what would you do if you were Enoch. You would get on your hand-crank bike-chair everyday in the hot African sun and get what you could to support your family.

Why does this encounter sit so strongly with me? I guess because someone like Enoch would have such a different life if he were living in a developed country. He is bright and is completely functional except for the paralysis of his lower extremities. In the US he could have accessed a full (free and appropriate) education, upon completing his education there would be a transition plan in place, he could enter public buildings (even past the 1st floor in most) and use public transportation, he could get on and off of the sidewalks (curb cuts), he could work in a variety of industries and given his strong work ethic I'm sure he would do quite well in many areas.

Not to toot our own horn (because TRUST ME, I know our system has flaws) but our supports here in the US are light years ahead of many places in the developing world. I know that Ghana is working in the right direction; but the problems faced by Enoch and others like him seem so HUGE.

I want to help, I really do. But right now, all I can think to do is listen, to be his friend, and to tell his story. There is a lot of work to be done on so many levels and the supports will have to come from the top (government) down for anything to have a real and lasting impact. To get the governments attention people will need to speak out, speak up, and "get a little mad". My advice to Enoch, shout loud enough for someone in the government to hear.

Wednesday, July 1, 2009

So I have been showing my son pictures from the blogs and he wants a post all to himself. Since this is a blog about Ghana, and my son is adopted from Ghana, I figured it was OK. So here it is.

Daniel will be turning 8 years old on July 8th. On July 9th, we will celebrate his "gotcha day", which is the day that I picked him up from Ghana (his official adoption day is Valentines day but it took us several months to get his passport so he could come home). This year will mark 2 years of being my son and being a US citizen. He is a pretty amazing kid. He will be going into the second grade next year and is an avid reader (6th grade level according to test scores). This summer he is reading the Ramona series (which I also enjoy)and I am reading Coraline to him by Neil Gaiman (which he says isn't scary but it give me the creeps).

In the spring he made the U9 travel soccer team for the Richmond Kickers, so he will be getting ready for "big boy soccer" this summer. He likes to play just about any sport there is; his favorites being soccer, wrestling, basketball, baseball, tennis, running, and jump rope. He loves to dance but will now only do it when he thinks no one is looking. He likes to show off his "guns" (muscles) and there isn't a mirror that he doesn't like. He is proud that he is a fast runner.

I think Daniel is exceptional. Truely an exception. All of the studies say that older child adoptions are risky. That children that have spent so much of their time in an orphanage are bound to have issues and delays. Now, by no means is Daniel perfect, but I think he is the most resilient child that I have ever met and his tenacity and strength have helped him to overcome and transition through all sorts of changes in his life. I know I am very lucky and blessed to have found him; in a rural village in Africa of all places. I'm sure he will continue to amaze me and everyone else he gets to meet in his life.

Here are some pictures of my crazy, fun, and amazing (almost) 8 year old boy:

Ok, so one of my personal goals for this trip was to learn how to wrap and carry a baby on my back. The women (and girls) in Ghana do this with such ease and grace (usually with something balanced on their head at the same time); I have just always wanted to be able to learn this skill. Well, the kids at the Sunday feeding program were eager to teach me, but as you can see from the picture above, the baby was not so willing. He was pretty freaked out by the white Americans and became quite distressed at being strapped onto my back. Oh, well, maybe next trip I can find a more willing baby and practice my skill a bit more!

About Me

I am an associate professor at Virginia Commonwealth University. I lead an annual study abroad trip to Ghana with occupational therapy students and clinicians. Part of their assignment is to blog about their experiences before, during and after the trip. I have set up this blog to 1) reflect on this course and what I want us to accomplish as OT's in Ghana and 2) to share our experiences with others interested in working in Ghana or other developing countries.